EDWIN RAY COLEMAN SR.


Address: 2614 Crenshaw Blvd., Los Angeles, CA 90016
Phone: 3102305574

EDWIN RAY COLEMAN SR. (NPI# 1558635789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1558635789
Entity Type Individual
Full Name EDWIN RAY COLEMAN SR.
Practice Address 2614 Crenshaw Blvd.
Los Angeles
CA 90016
Mailing Address 3026 9 Th Ave
Los Angeles
CA 90028
Practice Telephone 3102305574
Practice Fax Number 3233739786
Mailing Telephone 3234612817
Mailing Fax Number 3233739786
Enumeration Date 2012-03-06
Last Update Date 2012-03-21
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
Behavioral Health & Social Service Providers

Office Location

Street Address 2614 CRENSHAW BLVD.
City LOS ANGELES
State CA
Zip Code 90016

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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

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Competitor

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City LOS ANGELES
Zip Code 90016

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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